Revocation of Authorization

This form is to revoke my previous authorization for Tompkins Bank of Castile to authorize and pay overdrafts on my ATM and everyday debit card transactions.

Leave me blank for Revoke.

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I,

Name *

, understand that by submitting this form, I am confirming my revocation that Tompkins Bank of Castile will no longer authorize and pay overdrafts for ATM and Everyday debit card transactions for the following accounts: (Please list each account number separately)